Kaplan Aslı, Özel Ayşegül, Yalçınkaya Cem, Özyılmaz Safa, Kale İbrahim, Muhcu Murat
Department of Obstetrics and Gynecology, Umraniye Training and Research Hospital, Istanbul, Turkey.
Department of Obstetrics and Gynecology, Maternal Fetal Unit, Umraniye Training and Research Hospital, Istanbul, Turkey.
Z Geburtshilfe Neonatol. 2025 Feb;229(1):22-28. doi: 10.1055/a-2371-1856. Epub 2024 Aug 19.
Preeclampsia, whose pathophysiology is still not fully elucidated today, is a pregnancy-specific disease that affects most organ systems in pregnant women, including the central nervous system. In this context, we aimed to investigate the effects of preeclampsia on blood flow in the ophthalmic artery of the eye, which is considered a part of the central nervous system.
This prospective, non-interventional cohort study was conducted between February 2022 and June 2022 at Umraniye Training and Research Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey. Forty-six normotensive healthy pregnant women constituted the control group and 46 preeclamptic pregnant women constituted the preeclampsia group. Prenatal follow-up and delivery of the participants were carried out in our clinic. First, an obstetric ultrasound was performed on all participants with the same ultrasound device and the same clinician. Then, Doppler measurements of the ophthalmic artery of both eyes were made by the same clinician using the linear probe of the same ultrasound. Both groups were compared in terms of the first peak of systolic velocity (PSV), second PSV, pulsatility index (PI), PSV ratio, end-diastolic velocity (EDV), resistance index (RI), and systolic/diastolic ratio (S/D) measurements of the ophthalmic artery. RESULTS : The first PSV, second PSV, PSV ratio, and EDV were significantly higher in the preeclampsia group than in the control group (p=0.001, p<0.001, p=0.019, p<0.001, respectively). According to the receiver operating characteristic analysis, the second PSV with a cut-off value of 43.75 cm/s was the most powerful ophthalmic artery Doppler parameter in detecting preeclampsia with 63% sensitivity and 63% specificity. No significant difference was found between the early and late onset or mild and severe preeclampsia groups in terms of ophthalmic artery Doppler parameters.
Although the number of participants was too small to draw a definitive conclusion, the second PSV seems to be the most powerful parameter for the detection of preeclampsia. Studies with larger series are needed to determine the usability of ophthalmic artery Doppler parameters in the routine clinical diagnosis of preeclampsia and follow-up of the disease.
子痫前期是一种特定于妊娠的疾病，会影响孕妇的大多数器官系统，包括中枢神经系统，其病理生理学至今仍未完全阐明。在此背景下，我们旨在研究子痫前期对眼部眼动脉血流的影响，眼动脉被视为中枢神经系统的一部分。
这项前瞻性、非干预性队列研究于2022年2月至2022年6月在土耳其伊斯坦布尔乌姆拉尼耶培训与研究医院妇产科进行。46名血压正常的健康孕妇组成对照组，46名单纯收缩期高血压孕妇组成子痫前期组。参与者在我们的诊所进行产前随访和分娩。首先，使用同一超声设备和同一位临床医生对所有参与者进行产科超声检查。然后，同一位临床医生使用同一超声的线性探头对双眼的眼动脉进行多普勒测量。比较两组眼动脉的收缩期峰值流速（PSV）第一个峰值、第二个PSV、搏动指数（PI）、PSV比值、舒张末期流速（EDV）、阻力指数（RI）和收缩/舒张比（S/D）测量值。结果：子痫前期组的第一个PSV、第二个PSV、PSV比值和EDV显著高于对照组（分别为p = 0.001、p < 0.001、p = 0.019、p < 0.001）。根据受试者工作特征分析，第二个PSV的截断值为43.75 cm/s，是检测子痫前期最有效的眼动脉多普勒参数，灵敏度为63%，特异度为63%。早发型和晚发型或轻度和重度子痫前期组在眼动脉多普勒参数方面未发现显著差异。
尽管参与者数量过少，无法得出明确结论，但第二个PSV似乎是检测子痫前期最有效的参数。需要进行更大样本量的研究，以确定眼动脉多普勒参数在子痫前期常规临床诊断和疾病随访中的可用性。
